How to Use an Adrenaline Auto-Injector

In anaphylaxis, minutes matter. Adrenaline is the first and most important treatment, and an auto-injector lets anyone give it quickly. If someone you know carries one, learning how to use it could save their life.

Imagine your friend’s lips swelling at a restaurant, then her voice going hoarse and her breathing becoming noisy. She fumbles for her pen. You’ve practised with a trainer pen, so you take it, press it firmly into her outer thigh and call an ambulance. Within minutes her breathing eases.

Signs of anaphylaxis

• Airway: swollen tongue or throat, hoarse voice, difficulty swallowing
• Breathing: wheeze, persistent cough, noisy or difficult breathing
• Circulation: dizziness, collapse, pale or floppy (in children)

Hives, swelling of lips or eyes and vomiting may also appear, but some people have no skin signs. If in doubt, give adrenaline.

Using the pen: general steps

1. Remove the safety cap (check your brand’s instructions, as designs differ).
2. Hold the pen in your fist, tip pointing down. Never put your thumb over either end.
3. Press the tip firmly into the outer middle of the thigh. It works through clothing.
4. Hold in place for the time stated on the device (often 3 to 10 seconds).
5. Remove and gently massage the area if advised by the manufacturer.
6. Call emergency services and say “anaphylaxis”.

But what happens afterwards?

• Lay the person flat with legs raised. If breathing is hard, let them sit up. Don’t let them stand or walk.
• If there’s no improvement after 5 minutes, give a second pen if available.
• Always go to hospital, even if they feel better, because symptoms can return.
• If they stop breathing, start CPR.

People with severe allergies are usually advised to carry two pens at all times and check expiry dates regularly.

Sources: Resuscitation Council UK (Anaphylaxis), World Allergy Organization, Anaphylaxis UK, Australasian Society of Clinical Immunology and Allergy (ASCIA).